A sample of South Australian citizens has called for more accountability from companies such as McDonald’s. A consumer study conducted by the Southgate Institute for Health, Society and Equity at Flinders University in the form of a citizens’ jury resulted in a majority verdict in favour of increased government regulation of some of the ultraprocessed products and Australian corporate operations of McDonald’s, even if it means paying more for their products. Government measures to tackle McDonald’s advertising to children and young people, the unhealthy and fattening nature of some food products, and practices to reduce tax paid in Australia were supported by the 15 adult “citizen jurists”. The panel heard the results of a corporate health impact assessment of McDonald’s Australia conducted by the Southgate Institute. The assessment found that some of McDonald’s products and practices, such as unhealthy foods and advertising targeting children, are likely to have a negative impact on health. However, the research also found that McDonald’s practices in areas such as employment and sustainability, on balance, were likely to be positive for health. A food industry representative and two public health professionals also made presentations to the jury on the pluses and minuses of major food corporations such as McDonald’s in Australia. The feedback from the one-day citizens’ jury included public support for greater regulation of the fast food industry, such as greater regulation of transnational corporations tax minimisation practices, with jurors calling for changes to protect public revenue and promote equity; and two-thirds of the jury called for more regulation of fast food advertising and improved standards of consumer information with the aim of improving health. A minority of jurors said existing regulations were adequate to enable McDonald’s to operate freely and for individuals to take responsibility for their own diet and health. The study was published in the Australian and New Zealand Journal of Public Health.

Personalised cancer therapy could be a step closer

Researchers from the Peter MacCallum Cancer Centre have found that the efficacy of a cancer drug that blocks the activity of HER proteins depends on gene mutation and tissue type, and response was restricted to cancers with HER2 mutants. Published by Nature, the clinical trial highlighted how molecularly driven clinical trials can be used to enhance our understanding of the effects of genetic mutations, a finding that could aid the development of personalised cancer therapies. Various mutations in the HER2 and HER3 genes are found in a wide range of cancers. Some of these mutations cause overexpression of the HER2 protein, leading to cancer, but most are uncharacterised. The researchers tested the efficacy of neratinib, a drug that blocks the activity of HER proteins, in 141 patients with a variety of cancers, including breast, lung, bladder and colorectal, and a variety of different mutations in the HER2 and HER3 genes. They found that the response to treatment was determined by mutation and tissue type, and was restricted to cancers with HER2 mutants. The move towards personalised cancer therapies has been hampered because the clinical and biological importance of most genomic variants is unknown. This study helps to change that, providing new insights that were not predicted by pre-clinical models. It also highlights the value of so-called basket trials, which focus on a mutation type, such as those found in the HER genes, rather than the tissue in which the cancer appears.

Mums aged over 40 years could have highest premature birth risk

Pregnant mothers aged 40 years and over may have an increased risk for preterm birth, regardless of confounding factors, according to a Canadian study published in PLOS ONE. The researchers sought to investigate the impact of maternal age on preterm birth in a large cohort. They analysed the previously-collected data from the QUARISMA (Quality of Care, Obstetrics Risk Management, and Mode of Delivery) randomised control trial, which had taken place in 32 hospitals in Quebec, Canada, from 2008 to 2011. The researchers identified five different age groups among the 165 282 pregnancies included in the study, and compared them based on maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Some of the known risk factors identified more commonly in older mothers (aged 40 years and over) included placental praevia, gestational diabetes, medical history, use of assisted reproduction technologies and occurrence of an invasive procedure. On the other hand, nulliparity, past drug use and smoking were more prevalent in younger mothers (aged 30 years and under). Even after adjusting for confounding factors, the researchers found that advanced maternal age (40 years or over) was associated with preterm birth. Meanwhile, a maternal age of 30–34 years was associated with the lowest risk of prematurity.

Chronic diseases predispose to more than a fifth of new cancer cases

Several common chronic diseases together predispose to more than a fifth of new cancer cases and more than a third of cancer deaths, according to a study published by The BMJ. The findings show that the cancer risks from common chronic diseases, such as heart disease and diabetes, are as important as those from five major lifestyle factors combined. A team of researchers based in the US and Taiwan investigated the combined effect of eight common chronic diseases or disease markers (for example, high blood pressure as a marker of heart disease) on cancer risk compared with lifestyle factors. They also explored whether physical activity could reduce the cancer risk associated with chronic diseases and disease markers. The study involved 405 878 men and women in Taiwan with no history of cancer who completed a questionnaire and underwent a series of medical tests between 1996 and 2007. Participants were followed for an average of 8.7 years. The researchers found that cardiovascular disease markers, diabetes, chronic kidney disease markers, pulmonary disease, and gouty arthritis markers were individually associated with risk of developing cancer or cancer death. Higher chronic disease risk scores based on these diseases or markers were linked with an increased risk of developing cancer and cancer death, with the highest level associated with a more than twofold increase in risk of developing cancer and a fourfold increase in risk of cancer death. High chronic disease risk scores were also associated with substantial reduction in life span. The highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. Together, these chronic diseases and markers were present in more than one fifth of all new cancers and more than one third of all cancer deaths in this study population, which was similar to the contribution of five major lifestyle risk factors combined — smoking, insufficient physical activity, insufficient fruit and vegetable intake, alcohol consumption, and obesity. The researchers also found that physical activity was associated with a nearly 40% reduction in the excess risk of cancer and cancer death associated with chronic diseases and markers. The authors point out that chronic diseases are not targeted in current cancer prevention strategies, and say their findings have important implications for developing new strategies that target chronic diseases.

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